| NPI | 1750783866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2017011733) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-76505-012) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2022-10-06 |