NPI | 1548251630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ RN 103594 #702) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F330925) |
363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340487) | |
Enumeration Date | 2005-10-29 |
Last Update Date | 2023-03-07 |