NPI | 1205496361 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 206525) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 206525) |
363LG0600X Nurse Practitioner, Gerontology (Licence: LA 206525) | |
Enumeration Date | 2019-06-19 |
Last Update Date | 2019-06-19 |