| NPI | 1962804880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3008785) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3008785) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2020-10-23 |