| NPI | 1003298100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN243783) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN APN0000020054) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN243783) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-11-04 |