| NPI | 1821336140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP016764) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306315-1) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP016764) | |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2019-09-03 |