| NPI | 1962645663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30304943) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 34340718) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2009-04-10 |