| NPI | 1811473028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC AG06180230) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5010812) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NC 5010812) | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2024-10-10 |