NPI | 1063186948 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 9753) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11147) |
Enumeration Date | 2021-08-04 |
Last Update Date | 2023-05-23 |