| NPI | 1124058789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 87006599N4) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 087006599N4 GNPPP) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-02-28 |