| NPI | 1306240882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F307996-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5809) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 5809) | |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2020-11-11 |