| NPI | 1801456165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71009310A) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3013448) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2020-07-24 |