| NPI | 1336780105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 10041951) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019038069) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 363LG0600X) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2025-06-11 |