| NPI | 1821442633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20096) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 20096) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 20096) | |
| Enumeration Date | 2016-04-18 | 
| Last Update Date | 2024-11-13 |