NPI | 1104504398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 4006778) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4006778) |
Enumeration Date | 2023-07-07 |
Last Update Date | 2023-08-02 |