NPI | 1619408341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9167575) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9167575) |
163W00000X Registered Nurse (Licence: FL RN9167575) | |
Enumeration Date | 2017-03-24 |
Last Update Date | 2023-06-19 |