NPI | 1013454073 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20716) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 20716) |
Enumeration Date | 2017-01-27 |
Last Update Date | 2024-01-24 |