| NPI | 1992460513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 25777) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC ag11200044) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2022-02-22 |