| NPI | 1114204419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: OH NP020610) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: CT 004979) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MA RN2290435) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2021-07-08 |