NPI | 1376012831 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5015223) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 321771) |
163W00000X Registered Nurse (Licence: MN 2082592) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: MN 6256) | |
Enumeration Date | 2018-11-14 |
Last Update Date | 2021-12-08 |