| NPI | 1326028861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: SC 28215A) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 141718) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-02-13 |