NPI | 1710036686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN139646) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 139646) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2023-10-04 |