| NPI | 1770672974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 21813) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 667255) |
| 163W00000X Registered Nurse (Licence: CA 757947) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-05-01 |