NPI | 1780244525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD CP002340) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IA H154899) |
Enumeration Date | 2019-06-14 |
Last Update Date | 2025-01-16 |