| NPI | 1598210957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008829) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NC 5008829) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5008829) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2016-10-04 |