| NPI | 1770065559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95009860) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95009860) |
| 363L00000X Nurse Practitioner (Licence: CA 95009860) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2022-06-06 |