| NPI | 1336603976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP138262) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP138262) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2020-05-06 |