| NPI | 1669230991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1111111) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 1111111) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-08-17 |