| NPI | 1730837113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024186199) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: VA 0024186199) | |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2026-05-12 |