| NPI | 1801992466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: WA AP30004243) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MT 31549) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2015-09-28 |