| NPI | 1306421276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ 247587) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 247587) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 247587) | |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2026-05-28 |