| NPI | 1255653150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP144174) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP05474400) |
| 363L00000X Nurse Practitioner (Licence: TX AP144174) | |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2023-04-12 |