NPI | 1407392640 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9388580) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9388580) |
Enumeration Date | 2017-01-11 |
Last Update Date | 2022-03-02 |