| NPI | 1700499134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R172449) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R172449) | 
| Enumeration Date | 2020-08-25 | 
| Last Update Date | 2020-08-25 |