NPI | 1255867834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95006173) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95091478) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2018-03-17 |