| NPI | 1225707953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 10881) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 10881-33) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 10881) | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-01-12 |