| NPI | 1164601225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F304754-1) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NY F340688-1) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |