NPI | 1124663653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 8583) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8583) |
Enumeration Date | 2019-11-07 |
Last Update Date | 2021-07-15 |