| NPI | 1659942894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5018514) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11014121) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11014121) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11014121) | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2023-08-15 |