NPI | 1619597721 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-164575) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-164575) |
Enumeration Date | 2020-04-18 |
Last Update Date | 2023-03-09 |