| NPI | 1710213251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NN07764000) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA TP000803H) |
| Enumeration Date | 2009-10-18 |
| Last Update Date | 2011-02-24 |