NPI | 1851012801 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R235995) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WV 114003) |
Enumeration Date | 2022-09-08 |
Last Update Date | 2022-10-20 |