| NPI | 1013968148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM CNP01391) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R161673) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP01391) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2018-08-10 |