| NPI | 1710924774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 27676) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 073852) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2013-07-31 |