| NPI | 1790452431 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71012711A)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28210757A)  | 
| Enumeration Date | 2021-08-29 | 
| Last Update Date | 2022-09-20 |