| NPI | 1821661810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM 67996) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2021019692) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NM 67996) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209023478) | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-03-18 |