| NPI | 1619494663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024176831) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024176831) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2021-08-04 |