| NPI | 1013552587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23615) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5012875) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 23614) | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2022-10-31 |