NPI | 1790966190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 84728) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK R0084728) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2015-02-13 |