| NPI | 1053782417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3009684) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 3009684) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3009684) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2021-02-22 |