NPI | 1043912298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 13475405-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.453580) |
363LP2300X Nurse Practitioner, Primary Care (Licence: UT 13475405-4405) | |
Enumeration Date | 2023-03-21 |
Last Update Date | 2025-08-28 |