NPI | 1902380124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 27003) |
Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology (Licence: TN 225595) |
363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3012853) | |
Enumeration Date | 2018-09-24 |
Last Update Date | 2024-04-09 |