| NPI | 1215992441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO 56865) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN035583) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-08-28 |