| NPI | 1164202495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 311555) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 38125) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: VA 0024188620) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NY 311555) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: NY 311555) | |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2025-03-12 |