| NPI | 1609461599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 46259) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: WY 46259) |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2021-09-27 |