| NPI | 1194072298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 310948) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 655846) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310948) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2023-10-11 |