| NPI | 1649761040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 007269) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: CT 7269) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-07-24 |