NPI | 1366028813 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R193310) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WV 108726) |
Enumeration Date | 2021-03-23 |
Last Update Date | 2023-06-07 |