| NPI | 1093791055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AZ RN051010) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: AZ RN051010) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-08 |