NPI | 1700542040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 34002) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 34002) |
363L00000X Nurse Practitioner (Licence: TN 34002) | |
Enumeration Date | 2021-11-11 |
Last Update Date | 2025-05-19 |