| NPI | 1043675952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY AG1115073) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY AG1115073) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY AG1115073) | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2016-05-03 |