| NPI | 1194189597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71010979A) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA 18918 NP) |
| 363L00000X Nurse Practitioner (Licence: KY 3015910) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2023-02-16 |