| NPI | 1073602348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 0050-00502) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NC 0050-00502) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2021-08-18 |