| NPI | 1629144902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SD CP000265) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: SD CP000265) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |