| NPI | 1013572486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IA H154470) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IA H154470) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |