| NPI | 1912487422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 21544) |
| Additional Taxonomies | 208800000X Urology (Licence: SC 21544) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 21544) | |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2019-03-19 |