NPI | 1053366450 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 239178) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 239178) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MA 239178) | |
Enumeration Date | 2006-05-23 |
Last Update Date | 2024-11-11 |