NPI | 1912529009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 24090) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 93302) |
Enumeration Date | 2020-05-11 |
Last Update Date | 2022-01-23 |