| NPI | 1023711751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1117021) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 766180) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-05-02 |