NPI | 1407321169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95014452) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95014452) |
Enumeration Date | 2018-10-09 |
Last Update Date | 2024-09-13 |