| NPI | 1912648262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 4020281) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4020281) |
| 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: KY 4020281) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX 1055871) | |
| 363L00000X Nurse Practitioner (Licence: TX 2021085527) | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2024-05-28 |