NPI | 1174119820 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11010413) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11010413) |
Enumeration Date | 2020-12-16 |
Last Update Date | 2025-04-16 |