| NPI | 1851620009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3008058) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN171650 NP) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2020-06-29 |