| NPI | 1649677394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024172197) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 002417219) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024172197) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2024-03-08 |