NPI | 1972900397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 19383) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: KY 363LA2200X) |
363LG0600X Nurse Practitioner, Gerontology (Licence: TN 19383) | |
Enumeration Date | 2014-12-01 |
Last Update Date | 2022-03-28 |