| NPI | 1821553470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP019167) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SPO19167) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP019167) | |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-10-22 |