| NPI | 1811505803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: OH APRN.CNP.0034578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 80274) |
| 363L00000X Nurse Practitioner (Licence: AR 125505) | |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2024-08-15 |