| NPI | 1497379333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP022063) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95014600) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: CA 95014600) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP022063) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95014600) | |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2023-03-06 |