| NPI | 1356656763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306361) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 569215) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340890) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2013-12-20 |