| NPI | 1962824680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71007506A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209011132) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71007506A) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209011132) | |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2021-03-18 |