| NPI | 1306355060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24881) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5009688) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5009688) | |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2021-10-25 |