| NPI | 1124721659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: TX 1112578) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1112578) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2023-05-15 |