| NPI | 1013187236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WY 10367.0054) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: WY 10367.0054) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-05-06 |