NPI | 1053977892 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP138400) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP138400) |
Enumeration Date | 2019-05-16 |
Last Update Date | 2021-05-26 |