| NPI | 1104366038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009267) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5009267) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5009267) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5009267) | |
| Enumeration Date | 2017-02-25 |
| Last Update Date | 2021-09-24 |