| NPI | 1720308430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71012106A) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: IN 28146540A) |
| 363L00000X Nurse Practitioner (Licence: IN 71012106A) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2024-04-14 |