NPI | 1619357050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS R869134) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1030171) |
Enumeration Date | 2015-06-01 |
Last Update Date | 2023-07-24 |