| NPI | 1407924038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 3405971) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 303968-1) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2015-08-04 |