NPI | 1013596089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS R904555) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS R904555) |
Enumeration Date | 2021-04-06 |
Last Update Date | 2024-10-22 |