| NPI | 1992477814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024185456) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MN 8235) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2023-03-08 |