| NPI | 1104262047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95013191) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95201926) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: DC RN1054984) | |
| 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: MD R172460) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: DC RN1054984) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95013191) | |
| Enumeration Date | 2013-05-20 | 
| Last Update Date | 2022-07-29 |