NPI | 1679069157 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9473943) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN9473943) |
363LG0600X Nurse Practitioner, Gerontology (Licence: FL AG06180195) | |
Enumeration Date | 2018-07-07 |
Last Update Date | 2024-05-22 |