NPI | 1023795416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 12234) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 69358) |
Enumeration Date | 2023-06-28 |
Last Update Date | 2024-04-17 |