| NPI | 1720125834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: GA RN123591) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: GA 123591) |
| 171M00000X Case Manager/Care Coordinator (Licence: GA 123591) | |
| 363LF0000X Nurse Practitioner Family (Licence: GA 123591) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-01-11 |