| NPI | 1669816831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP60691550) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 17563) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2020-12-01 |