| NPI | 1033512595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95004253) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2285119) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 1033512595) | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2020-12-10 |