| NPI | 1396292421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: ID 60046) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: AZ RN201537) |
| 363L00000X Nurse Practitioner (Licence: ID NP60046) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: ID 60046) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: ID 60046) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2021-07-16 |