| NPI | 1366806770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 9277493) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: FL 9277493) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: FL 9277493) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2017-04-12 |