| NPI | 1053716142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 18931) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 18931) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 18931) | |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2015-07-09 |