| NPI | 1003078262 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 3621)  | 
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: SC 3621)  | 
| Enumeration Date | 2008-06-30 | 
| Last Update Date | 2008-06-30 |