| NPI | 1407090053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 3859) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: SC 3859) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2015-02-12 |