NPI | 1124491584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN APN20467) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 20467) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TN APN20467) | |
Enumeration Date | 2015-11-07 |
Last Update Date | 2022-03-29 |