NPI | 1124522875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 22096) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5010356) |
Enumeration Date | 2018-03-19 |
Last Update Date | 2022-11-02 |