NPI | 1568983765 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209.016112) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209.016112) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2020-10-09 |