| NPI | 1457704041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112058) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NE 112058) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NE 112058) | |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-20 |