NPI | 1629776802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3018733) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3018733) |
Enumeration Date | 2023-02-17 |
Last Update Date | 2023-09-14 |