| NPI | 1063991388 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ AP11532) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP11532) | 
| Enumeration Date | 2018-08-08 | 
| Last Update Date | 2018-08-08 |