| NPI | 1801203708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 18937) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 18937) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2021-05-19 |