NPI | 1063398642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11041909) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 9443891) |
Enumeration Date | 2025-08-11 |
Last Update Date | 2025-08-27 |