| NPI | 1962911933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95006972) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95006972) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2020-11-11 |