| NPI | 1659755585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 19599) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 19599) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2018-03-17 |