| NPI | 1962887984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: FL APRN9405427) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9405427) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2019-11-12 |