| NPI | 1013553098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2021048774) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0994282) |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2022-11-02 |