| NPI | 1649654880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3009100) |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: KY 3009100) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3009100) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-09-23 |