| NPI | 1164739777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP010726) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010726) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2016-11-10 |