NPI | 1013504836 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: ID 67009) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-34627) |
Enumeration Date | 2020-12-28 |
Last Update Date | 2021-01-17 |