| 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 | 2026-02-03 |