| NPI | 1700402674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013215) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: NC 277814) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2021-10-21 |