NPI | 1457830309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 12.007736) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 12.007736) |
Enumeration Date | 2018-08-11 |
Last Update Date | 2018-11-12 |