| NPI | 1700517018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11016630) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: FL 11016630) |
| 363L00000X Nurse Practitioner (Licence: FL 11016630) | |
| Enumeration Date | 2022-06-19 |
| Last Update Date | 2022-12-05 |