| NPI | 1912394149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 17571) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: CA 2803) |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2015-04-26 |