| NPI | 1154743839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1094168) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2023-01-25 |