| NPI | 1508857095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AZ RN081159) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 200550137NP) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: OR 200550138NP) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-06-04 |