| NPI | 1730775164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3015164) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28231165A) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71010686A) | |
| Enumeration Date | 2020-12-20 |
| Last Update Date | 2022-08-02 |