| NPI | 1982619474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 078042039RN) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OR 078042039N4) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-05-02 |