| NPI | 1609144369 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: DC 2007004897) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5004024) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 011914) | |
| Enumeration Date | 2011-12-09 | 
| Last Update Date | 2013-08-27 |