| NPI | 1629464110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN203684) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: GA RN203684) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |