| NPI | 1306808761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 600115) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 098821) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-07-16 |