NPI | 1942800768 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 326192) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R50092) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704311240NSA200T8) | |
Enumeration Date | 2020-10-30 |
Last Update Date | 2025-07-14 |