NPI | 1356793624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9327066) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9327066) |
Enumeration Date | 2016-07-11 |
Last Update Date | 2020-06-17 |