| NPI | 1134703754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP141408) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AG03190020) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-05-10 |