| NPI | 1407239767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3010585) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH Credential License) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2022-07-21 |