NPI | 1417626615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1057770) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 870531) |
Enumeration Date | 2021-09-10 |
Last Update Date | 2023-05-26 |