| NPI | 1083624332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP001803H) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN239523L) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2009-10-15 |