| NPI | 1962061101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024185244) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001325) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024185244) | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2024-04-29 |