NPI | 1073914404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R225313) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IA H117701) |
363LG0600X Nurse Practitioner, Gerontology (Licence: IA H117701) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: IA H117701) | |
163W00000X Registered Nurse (Licence: MD R225313) | |
Enumeration Date | 2014-09-04 |
Last Update Date | 2017-01-04 |