| NPI | 1306395264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 21750) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TN 21750) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |