| NPI | 1104464551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024178496) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024178496) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024178496) | |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2020-06-16 |