NPI | 1558975508 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R158868) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R158868) |
Enumeration Date | 2020-09-06 |
Last Update Date | 2020-09-06 |