| NPI | 1306407903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MO 2019007755) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MO 2019007755) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |