NPI | 1104981224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R128753) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: DE LD-0000115) |
363LG0600X Nurse Practitioner, Gerontology (Licence: DC RN1006277) | |
Enumeration Date | 2006-12-27 |
Last Update Date | 2007-07-08 |