| NPI | 1578514790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: NM CNP-01549) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TX 672791) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-07-13 |