NPI | 1942627039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R178330) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R178330) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MD R178330) | |
Enumeration Date | 2014-03-26 |
Last Update Date | 2017-10-11 |