| NPI | 1861745259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 001835) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340338-1) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2012-10-22 |