| NPI | 1174738678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: TX 825120) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: VA 0024167727) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2013-01-25 |