| NPI | 1124063300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005118) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200950150NP) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 99007553N4) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2019-03-29 |