| NPI | 1801308036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 23455) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN23455) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 23455) | |
| Enumeration Date | 2017-10-27 |
| Last Update Date | 2022-03-16 |