| NPI | 1790186328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5007196) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 206287) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2018-05-15 |