NPI | 1407847007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0001339767) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY f4207541) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305204-1) | |
Enumeration Date | 2005-11-02 |
Last Update Date | 2025-08-01 |