| NPI | 1649793068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95015396) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00785200) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95015396) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00785200) | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2020-09-18 |