| NPI | 1528412624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 10018726)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9165986)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61272607)  | |
| Enumeration Date | 2016-04-15 | 
| Last Update Date | 2024-01-31 |