| NPI | 1265630933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024168198) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024168198) |
| Enumeration Date | 2007-07-04 |
| Last Update Date | 2020-07-31 |