| NPI | 1912263609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024173081) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: VA 0001142669) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2016-02-12 |