NPI | 1114571098 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11003362) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11003362) |
Enumeration Date | 2019-07-29 |
Last Update Date | 2024-07-10 |