| NPI | 1396124079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007637) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5007637) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN074419) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5007637) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5007637) | |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2023-08-16 |