| NPI | 1194190579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1191083) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP015417) |
| 363L00000X Nurse Practitioner (Licence: GA RN285594) | |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2025-04-03 |