| NPI | 1972054807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-131058) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: AL 1-131058) |
| Enumeration Date | 2016-10-15 |
| Last Update Date | 2024-01-22 |