| NPI | 1982007878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017422) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LP-0000110) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TN LP-0000110) | |
| 163W00000X Registered Nurse (Licence: TN L1-0029955) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2020-04-14 |