| NPI | 1063917136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308295-1) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F308295-1) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2019-01-07 |