| NPI | 1518930734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 1978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 600139) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NC 600139) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: SC 1978) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2018-02-06 |