| NPI | 1780779389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: LA AP04300) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: LA RN078748) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-11-08 |