| NPI | 1376346429 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ID 7471392) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: AZ 224079) |
| Enumeration Date | 2025-03-31 |
| Last Update Date | 2026-02-03 |