| NPI | 1760488076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5009670) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 088713) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2018-05-04 |