NPI | 1306450119 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013465) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 5013465) |
363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013465) | |
Enumeration Date | 2020-08-31 |
Last Update Date | 2022-03-02 |