NPI | 1649817016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024183398) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95015949) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11002390) | |
Enumeration Date | 2019-12-04 |
Last Update Date | 2024-10-12 |