| NPI | 1265884779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 45037) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP018245) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP018245) | |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2020-10-15 |