| NPI | 1114940350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD R011406) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SD R011406) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |