| NPI | 1780664680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA NPF16312) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ RN030691) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2013-06-18 |