| NPI | 1265029060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2346908) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 28630) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 28630) | |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2022-03-28 |