| NPI | 1164416277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP0029) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2547) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2011-07-11 |