| NPI | 1578109427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5012986) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012986) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5012986) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2025-02-13 |