| NPI | 1629776984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024188273) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 256042) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024188273) | |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2025-01-10 |