NPI | 1114530078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11009028) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 645754) |
Enumeration Date | 2020-08-28 |
Last Update Date | 2024-12-17 |