NPI | 1477954600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209011765) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209011765) |
Enumeration Date | 2014-09-08 |
Last Update Date | 2019-08-24 |