NPI | 1104978360 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 53063) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN050601) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2010-03-22 |