NPI | 1306453683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL 11009365) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F310181) |
Enumeration Date | 2020-09-30 |
Last Update Date | 2024-10-29 |