| NPI | 1114539814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5013442) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5013442) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013442) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5013442) | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2021-02-24 |