| NPI | 1124449285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 193894-4405) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 193894-4405) |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2018-03-17 |