| NPI | 1710271382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP120276) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 670917) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2014-09-18 |