| NPI | 1790035004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340829) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305931) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2018-10-17 |