| NPI | 1902357510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN210936) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: GA RN210936) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |