NPI | 1013685205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1051895) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1051895) |
Enumeration Date | 2021-09-01 |
Last Update Date | 2022-03-14 |