NPI | 1790234615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP017313) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 26NJ00669400) |
Enumeration Date | 2016-10-04 |
Last Update Date | 2023-08-14 |