| NPI | 1518361682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 6072-33) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 6072-33) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.012158) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.012158) | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-12-16 |