| NPI | 1982987301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024169618) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340821-1) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2018-09-06 |