| NPI | 1043684673 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340917) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00545000) | 
| Enumeration Date | 2015-11-19 | 
| Last Update Date | 2016-10-22 |