| NPI | 1235588542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 225172) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3015736) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 225172) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2025-07-29 |