NPI | 1316549900 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11032241) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 28395) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TN 0000028395) | |
Enumeration Date | 2020-11-10 |
Last Update Date | 2024-08-12 |