NPI | 1710236039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 240229) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9245229) |
Enumeration Date | 2012-08-31 |
Last Update Date | 2018-04-19 |