NPI | 1982256475 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5012005) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 259884) |
Enumeration Date | 2019-07-15 |
Last Update Date | 2019-08-06 |