| NPI | 1811458003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3013118) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3013118) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2022-02-02 |