| NPI | 1215328174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2003005382) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2015003907) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2003005382) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2015003907) | |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2021-10-12 |