| NPI | 1972145084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: CA 95012783) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95012783) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2023-06-29 |