| NPI | 1972370047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 115119) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NE 115119) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NE 115119) | |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2024-02-22 |