| NPI | 1568430379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 041362173) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 083575) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2011-09-02 |