| NPI | 1760962823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP11386) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WA AP61507866) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2023-12-20 |