| NPI | 1508381039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2017029363) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MO AG07170077) |
| Enumeration Date | 2017-08-05 |
| Last Update Date | 2018-04-18 |