| NPI | 1558788968 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306416-1)  | 
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: NY F340915-1)  | 
| Enumeration Date | 2014-03-24 | 
| Last Update Date | 2017-05-18 |