| NPI | 1215914932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R156028) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: KS 45654) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2007-07-08 |