| NPI | 1992074322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP011302) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA sp011302) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2020-04-06 |