| NPI | 1093115503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KY 3008833) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: KY 3008833) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2019-03-13 |