NPI | 1740648419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 25502) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP130267) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TN 25502) | |
Enumeration Date | 2016-02-09 |
Last Update Date | 2022-03-23 |