NPI | 1336569680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1169164) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-100108) |
Enumeration Date | 2014-04-24 |
Last Update Date | 2024-08-26 |