| NPI | 1376620096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP111268) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 2-25518) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-12-16 |