| NPI | 1194193490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024191103) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA RN615464) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2025-06-10 |