| NPI | 1679121479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 8435) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8435) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-10-29 |