| NPI | 1811404775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MS 902335) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MS 902335) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: TN 23629) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TN 23629) | |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2018-10-08 |