NPI | 1104473214 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AR 121994) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AR 121994) |
363LP2300X Nurse Practitioner, Primary Care (Licence: AR 121994) | |
Enumeration Date | 2019-08-22 |
Last Update Date | 2023-11-06 |