| NPI | 1386662484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 21544) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI PPNS00073) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2012-02-02 |