| NPI | 1093867707 |
|---|---|
| Former Name | JENNIFER DOUGLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303891-1) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340587-1) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2024-12-12 |