| NPI | 1265836563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA 16234) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3012594) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2022-11-04 |