| NPI | 1902353980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3010275) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3010275) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2019-10-18 |