| NPI | 1801563572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5015450) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC CARL8dwfm) |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2022-01-19 |