| NPI | 1841062544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 4009904) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4009904) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4009904) | |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2025-12-03 |