| NPI | 1730168774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302486-1) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340378-1) | 
| Enumeration Date | 2006-01-10 | 
| Last Update Date | 2009-03-09 |