| NPI | 1639578628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: ID 60235) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: UT 9009534-4405) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2019-02-11 |