| NPI | 1609282391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP125351) |
| Additional Taxonomies | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: TX 767459) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |