| NPI | 1164523098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: AZ RN044136/APO199) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: AZ RN044136/APO199) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-03-30 |