NPI | 1649814187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95012563) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95012563) |
363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95012563) | |
Enumeration Date | 2019-10-28 |
Last Update Date | 2023-11-18 |