NPI | 1013408657 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9321594) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9321594) |
Enumeration Date | 2018-05-18 |
Last Update Date | 2019-07-25 |