NPI | 1679105654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95005352) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95005352) |
Enumeration Date | 2020-02-07 |
Last Update Date | 2022-08-25 |