| NPI | 1790880961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 16796) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MA 213285) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-04-17 |