| NPI | 1346792629 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306366) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 340894) | 
| Enumeration Date | 2016-11-02 | 
| Last Update Date | 2016-11-02 |