| NPI | 1174912406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3008878) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008878) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3008878) | |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2019-08-16 |