| NPI | 1740269927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD 146979-23) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD 149363-21) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2011-08-11 |