| NPI | 1790183283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5007376) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NC 5007376) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NC 5007376) | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2015-11-06 |