| NPI | 1013676949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3016453) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 3016453) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3016453) | |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2025-01-10 |