| NPI | 1174893754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F3083891) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 650721) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2018-05-29 |