| NPI | 1770175614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: ID NP67373) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 202102336NP-PP) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: ID NP67373) | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-05-04 |