| NPI | 1629697719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10221) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI mc6005878) | 
| 163WG0000X Registered Nurse, General Practice (Licence: WI 197980) | |
| Enumeration Date | 2020-04-09 | 
| Last Update Date | 2024-07-15 |