| NPI | 1851744007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN288572) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.019494) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2019-12-04 |