| NPI | 1861884215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN176193) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN176193) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2016-05-26 |