| NPI | 1912137860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN168654) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 14088) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN236561) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 14088) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 14088) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2024-03-05 |