| NPI | 1457921058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024182144) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5014612) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024182144) | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2023-08-30 |