| NPI | 1730648361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5011704) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5011704) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11001234) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5011704) | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-01-06 |