| NPI | 1255484952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA TP006236C) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA TP006235H) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2012-05-18 |