| NPI | 1184966541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 30306103) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist Gerontology (Licence: NY 34340848) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-03-25 |