NPI | 1053890004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209018017) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209018017) |
Enumeration Date | 2018-08-10 |
Last Update Date | 2018-09-07 |