| NPI | 1699223784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2019012933) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KS 5377354082) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5377354082) | |
| Enumeration Date | 2016-09-17 |
| Last Update Date | 2026-05-01 |