| NPI | 1043912298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 13475405-4405) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.453580) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 13475405-4405) | |
| Enumeration Date | 2023-03-21 | 
| Last Update Date | 2025-08-28 |