| NPI | 1619214814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 340549) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 476577) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2013-01-14 |