| NPI | 1760862684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024172629) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024172629) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172629) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2022-03-31 |