| NPI | 1366722308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP120706) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 721130) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2014-12-14 |