| NPI | 1710540745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11001993) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11001993) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11001993) | |
| Enumeration Date | 2019-04-16 | 
| Last Update Date | 2019-04-16 |