| NPI | 1710766795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 10016532) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 10016532) |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2024-02-02 |