| NPI | 1275850174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: CA 470884) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: GA 185863) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TX 817690) | |
| Enumeration Date | 2010-05-01 |
| Last Update Date | 2013-05-09 |