| NPI | 1548281785 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 6094) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN APN6094) | 
| Enumeration Date | 2006-07-22 | 
| Last Update Date | 2012-02-08 |