| NPI | 1861828832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ TAP11189) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 164362-30) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP11189) | |
| Enumeration Date | 2013-09-22 |
| Last Update Date | 2018-12-26 |