| NPI | 1790143618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 9466630) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 240511) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA 240511) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 240511) | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2025-12-18 |