| NPI | 1063815082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-157182) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 19242) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 19242) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-157182) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 19242) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 19242) | |
| Enumeration Date | 2014-10-04 |
| Last Update Date | 2023-06-30 |