| NPI | 1003488537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4704323196) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 21160071638) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704323196) | |
| Enumeration Date | 2021-07-14 | 
| Last Update Date | 2024-11-26 |