| NPI | 1811340508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-77085-091) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: KS 53-77085-091) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2018-04-05 |