| NPI | 1356816011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP139076) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP139076) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2022-01-04 |