NPI | 1811505803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OH APRN.CNP.0034578) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 80274) |
363L00000X Nurse Practitioner (Licence: AR 125505) | |
Enumeration Date | 2020-07-16 |
Last Update Date | 2024-08-15 |