| NPI | 1336691948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP016691) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: PA SP016691) |
| Enumeration Date | 2016-10-30 |
| Last Update Date | 2017-02-07 |