| NPI | 1619374105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014035640) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76515-112) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MT 103225) | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2023-11-14 |