NPI | 1508024894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 001156) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT R50878) |
363L00000X Nurse Practitioner (Licence: MA 184911) | |
363L00000X Nurse Practitioner (Licence: CT 1156) | |
Enumeration Date | 2008-05-23 |
Last Update Date | 2010-07-27 |