NPI | 1700329117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN321714) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP9401763) |
363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP015322) | |
Enumeration Date | 2016-12-02 |
Last Update Date | 2023-08-13 |