NPI | 1366161341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024185124) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024185124) |
Enumeration Date | 2022-08-24 |
Last Update Date | 2023-08-01 |