| NPI | 1073052619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9243641) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 9243641) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2018-07-26 |