| NPI | 1700271822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5010616) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 6308) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5010616) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2022-05-03 |