| NPI | 1679944904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IA H13167) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IA H13167) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: IA H13167) | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2019-07-15 |