| NPI | 1780744011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT 100988) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 11446) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2017-04-23 |