| NPI | 1629587530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024174999) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024174999) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2019-07-22 |