| NPI | 1104978360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 53063) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN050601) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2010-03-22 |