| NPI | 1841656659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP015835) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: PA SP015835) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |