NPI | 1538559190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN309281) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0001299163) |
363LG0600X Nurse Practitioner, Gerontology (Licence: RI APRN03074) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: IL 041426832) | |
Enumeration Date | 2015-02-03 |
Last Update Date | 2024-10-31 |