NPI | 1164800629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 19872) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 19872) |
Enumeration Date | 2015-05-15 |
Last Update Date | 2021-12-01 |