NPI | 1699916643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 20427) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH COA.10651-NP) |
Enumeration Date | 2009-03-19 |
Last Update Date | 2016-12-19 |