NPI | 1710505136 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1008458) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 2020038365) |
Enumeration Date | 2020-07-13 |
Last Update Date | 2021-09-27 |