| NPI | 1639659956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1141560) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71008194A) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2024-08-05 |