| NPI | 1215341037 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NY 306820)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F306820)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 306820)  | |
| Enumeration Date | 2014-06-19 | 
| Last Update Date | 2025-04-28 |