| NPI | 1013265966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 5173-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 175038-30) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2015-08-12 |