NPI | 1003096918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209-014168) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-251934) |
Enumeration Date | 2007-11-07 |
Last Update Date | 2016-10-06 |