| NPI | 1063948677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3011215) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71007176A) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3011215) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3011215) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2020-12-03 |