| NPI | 1780994392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: IN 28080868A) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: IN 28080868A) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |