NPI | 1790210029 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20953) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 20953) |
Enumeration Date | 2017-04-24 |
Last Update Date | 2021-05-27 |