NPI | 1336562172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5629) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5655) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5655) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: WI 5655) | |
Enumeration Date | 2014-01-30 |
Last Update Date | 2024-07-19 |