| NPI | 1417131038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: OK 49456) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 547215) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2015-09-09 |