| NPI | 1780100776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-140234) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-140234) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-140234) | |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2018-03-17 |