| NPI | 1104296979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F3074181) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F3074181) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2021-04-26 |