NPI | 1659925337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11002728) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11002728) |
Enumeration Date | 2019-07-30 |
Last Update Date | 2020-04-03 |