| NPI | 1366958092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95008078) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: CA 95008078) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |