NPI | 1871069096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-125066) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-125066) |
Enumeration Date | 2018-10-15 |
Last Update Date | 2022-01-31 |