| NPI | 1629400122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H072283) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H072283) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209010602) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H072283) | |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2018-05-17 |