| NPI | 1306453683 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11009365)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310181)  | 
| Enumeration Date | 2020-09-30 | 
| Last Update Date | 2024-10-29 |