NPI | 1417205451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 130332) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 3821) |
363L00000X Nurse Practitioner (Licence: MN 3821) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: WI F0612968) | |
Enumeration Date | 2012-08-23 |
Last Update Date | 2025-02-19 |