| NPI | 1497271415 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 902163)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 902163)  | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 902163)  | |
| Enumeration Date | 2017-08-22 | 
| Last Update Date | 2018-03-17 |