| NPI | 1124550256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: NC 5013054) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN230121) |
| 363L00000X Nurse Practitioner (Licence: TN 24522) | |
| 363L00000X Nurse Practitioner (Licence: SC APRN20875) | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2024-09-24 |