| NPI | 1992565303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 4017486) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 4017486) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4017486) | |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2026-04-29 |