NPI | 1912205154 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5005132) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005132) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5005132) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5005132) | |
Enumeration Date | 2011-03-12 |
Last Update Date | 2021-03-18 |