NPI | 1013569748 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: FL 11003106) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: FL 11003106) |
363LP2300X Nurse Practitioner Primary Care (Licence: FL 11003106) | |
Enumeration Date | 2019-07-12 |
Last Update Date | 2019-07-12 |