| NPI | 1235614645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 34839) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 257360) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2024-08-07 |