| NPI | 1235005992 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: NV 890797) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NV 890797) |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2025-10-10 |