NPI | 1578021796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP019871) |
Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: FL APRN11011179) |
363LG0600X Nurse Practitioner Gerontology (Licence: PA SP019871) | |
Enumeration Date | 2019-03-06 |
Last Update Date | 2023-01-11 |