| NPI | 1639848401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 71012051A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28226507) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-01-04 |