| NPI | 1316341688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 6075-33) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: WI 6075-33) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: WI 6075-33) | |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2015-04-23 |