| NPI | 1689147134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM 54914) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 54914) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-08-09 |