NPI | 1619642634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95018261) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CA 95139717) |
363L00000X Nurse Practitioner (Licence: CA 95018261) | |
Enumeration Date | 2021-08-11 |
Last Update Date | 2022-07-05 |