| NPI | 1386217685 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71011255A) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011255A) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2025-02-12 |