| NPI | 1982085155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 30693) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011585) |
| 363L00000X Nurse Practitioner (Licence: WI 6429) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3011585) | |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2022-03-15 |