| NPI | 1962561456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IA H-077485) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: IA J-077485) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-11-30 |