NPI | 1992303457 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 28266) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 28266) |
363LA2200X Nurse Practitioner, Adult Health (Licence: TN 28266) | |
Enumeration Date | 2020-10-15 |
Last Update Date | 2020-10-15 |