| NPI | 1407148042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 4101) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: WI 4101-033) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: WI 4101) | |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2015-06-05 |