| NPI | 1538056882 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1190202) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1190202) | 
| Enumeration Date | 2025-06-19 | 
| Last Update Date | 2025-10-03 |