| NPI | 1255192563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R228971) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R228971) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R228971) | |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-05-14 |