| NPI | 1225650542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014919) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: KY 1132083) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2021-07-19 |