| NPI | 1558816462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 21577) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 154994) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 159821) | |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2023-04-06 |