NPI | 1770988404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP014366) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN631972) |
Enumeration Date | 2014-10-23 |
Last Update Date | 2019-08-13 |