| NPI | 1902278773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2015037183) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MO 2015037183) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2021-11-12 |