| NPI | 1083322150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: UT 13072449-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 13072449-4405) |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-12-05 |