NPI | 1376172692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-171693) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA GAA-NP000597) |
Enumeration Date | 2020-04-07 |
Last Update Date | 2024-02-01 |