NPI | 1285415190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11028837) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11028837) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11028837) | |
Enumeration Date | 2023-10-09 |
Last Update Date | 2024-10-14 |