| NPI | 1053979708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-143276) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-143276) |
| 363L00000X Nurse Practitioner (Licence: AL 1-143276) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-143276) | |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-06-13 |