NPI | 1164068235 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-128337) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-128337) |
Enumeration Date | 2019-11-22 |
Last Update Date | 2023-01-27 |