NPI | 1124683636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AK 164897) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH 024445) |
Enumeration Date | 2019-05-09 |
Last Update Date | 2024-01-08 |