NPI | 1639398076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 210866) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 210866) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2007-07-13 |