| NPI | 1912375270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5008037) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5008037) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008037) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5008037) | |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2016-12-07 |