| NPI | 1699207613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 71007833A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6720-033) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2020-12-05 |