| NPI | 1710505136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1008458) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 2020038365) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-09-27 |