| NPI | 1972906576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306796) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 340934) |
| Enumeration Date | 2014-09-27 |
| Last Update Date | 2015-05-13 |