| NPI | 1164864203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30306471) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 30340916) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2022-08-24 |