NPI | 1609206630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 18489) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 18489) |
Enumeration Date | 2013-11-12 |
Last Update Date | 2023-01-18 |