| NPI | 1861622565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024169140) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD AC000941) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2012-02-08 |