| NPI | 1407208788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5008713) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008713) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5008713) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |