NPI | 1124535596 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NR21758700) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 242186) |
Enumeration Date | 2018-01-06 |
Last Update Date | 2021-04-29 |