| NPI | 1578978011 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP128230) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71004981A) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 28196100A) | |
| Enumeration Date | 2014-06-24 | 
| Last Update Date | 2019-10-28 |