| NPI | 1942793666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3012435) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1126430) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-07-06 |