NPI | 1518620731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11015161) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11015161) |
Enumeration Date | 2021-10-14 |
Last Update Date | 2022-11-08 |