NPI | 1366094914 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11018536) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 544669) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018536) | |
Enumeration Date | 2019-07-14 |
Last Update Date | 2024-07-08 |