| NPI | 1699441519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11005916) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11005916) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 11005916) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11005916) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11005916) | |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2024-01-12 |