| NPI | 1043683691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: WY 22630.1461) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: WY 22630.1461) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |