NPI | 1972163269 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 216045) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 216045) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NC 216045) | |
Enumeration Date | 2019-06-18 |
Last Update Date | 2019-06-18 |