| NPI | 1912567579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5011878) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011878) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |