| NPI | 1255972964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP1005162) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 8503) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2023-03-14 |