| NPI | 1861000440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024182790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001134354) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024182790) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2022-07-12 |