| NPI | 1710646187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5015543) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC Baum-SW1TR) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5015543) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5015543) | |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2024-04-02 |