| NPI | 1124063409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: KS 74269) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: KS 74269) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2023-02-23 |