NPI | 1003365842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209014109) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209014109) |
Enumeration Date | 2016-09-21 |
Last Update Date | 2020-10-07 |