NPI | 1104345750 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9310103) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9310103) |
363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9310103) | |
Enumeration Date | 2017-09-14 |
Last Update Date | 2021-07-29 |