| NPI | 1790867471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA AG0715012) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001235693) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: VA AG0715012) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-11-04 |