| NPI | 1083256788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 748391) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 309454) | |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2020-04-10 |