| NPI | 1508268913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: HI 1794) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: HI 1794) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2022-08-04 |