| NPI | 1609126630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F305724-1) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: NY F340814-1) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2019-07-09 |