NPI | 1821442633 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20096) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 20096) |
363LP2300X Nurse Practitioner, Primary Care (Licence: SC 20096) | |
Enumeration Date | 2016-04-18 |
Last Update Date | 2024-11-13 |