NPI | 1922533355 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA sp017345) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00751400) |
Enumeration Date | 2017-04-24 |
Last Update Date | 2024-04-11 |