| NPI | 1740557610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71003764A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28154814A) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2020-09-10 |