| NPI | 1053102772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MT 266773) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH APRN.CNP.0038481) |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-08-14 |