| NPI | 1265953756 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9291427) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL AG05170038) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL AG05170038) | |
| Enumeration Date | 2017-07-05 | 
| Last Update Date | 2019-09-03 |