| NPI | 1245896893 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019015725) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2019015725) | 
| Enumeration Date | 2019-05-18 | 
| Last Update Date | 2023-12-21 |