| NPI | 1861821357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA H111815) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IA J111815) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |