NPI | 1205211034 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F30744) |
Additional Taxonomies | 261QX0200X Clinic/Center, Oncology (Licence: NY 307441) |
Enumeration Date | 2015-07-22 |
Last Update Date | 2015-11-02 |