| NPI | 1003826991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH 0925) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 2351P) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 2351P) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2011-08-15 |