| NPI | 1104418557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1019365) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1019365) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2022-12-13 |