NPI | 1275185803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 11117) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA ARNP11001953) |
363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11001953) | |
Enumeration Date | 2019-07-13 |
Last Update Date | 2025-02-20 |