| NPI | 1164635306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP009425) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP009413) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2017-05-08 |