| NPI | 1760032031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024177829) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024177829) | 
| Enumeration Date | 2019-09-18 | 
| Last Update Date | 2019-09-18 |