| NPI | 1205204583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024183855) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5007867) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5007867) | |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2022-04-25 |