| NPI | 1053394486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 18325) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN086518) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2018-02-06 |