| NPI | 1174574842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP112948) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 613819) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-04-20 |