| NPI | 1174260277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP025734) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA 1265664544) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP025734) | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-05-20 |