| NPI | 1679892483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 763188) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 763188) |
| 363L00000X Nurse Practitioner (Licence: TX 763188) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2021-02-15 |