NPI | 1215251624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP146147) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95104584) |
363L00000X Nurse Practitioner (Licence: CA 95004930) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.016210) | |
Enumeration Date | 2010-03-15 |
Last Update Date | 2020-09-03 |