| NPI | 1821349051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5144-33) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 2012012414) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2014-01-17 |