| NPI | 1790966190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: OK 84728) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0084728) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2015-02-13 |