| NPI | 1730237876 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT rn20118)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MT rn20118)  | 
| Enumeration Date | 2007-01-08 | 
| Last Update Date | 2012-02-24 |