| NPI | 1174933352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306812-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 618270-1) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340944-1) | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-06-17 |