| NPI | 1104415231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1016419) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1016419) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2024-03-05 |