| NPI | 1154717098 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5007568)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5007568)  | 
| Enumeration Date | 2015-04-07 | 
| Last Update Date | 2023-06-07 |