| NPI | 1376536581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H086441) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H086441) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H086441) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2012-03-07 |