NPI | 1174113112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AG11200097) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX AG11200097) |
Enumeration Date | 2021-01-23 |
Last Update Date | 2024-10-30 |