| NPI | 1205919578 |
|---|---|
| Former Name | CHERYL MARIE FONAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: NY 340488) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NY F340488-1) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-04-27 |