| NPI | 1942651005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA AP08972) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 901493) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 901493) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 901493) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: LA AP08972) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2016-08-12 |