| NPI | 1760560957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000459 or RO34854) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SD CP000459) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |