| NPI | 1730775164 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1176645)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28231165A)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71010686A)  | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: KY 3015164)  | |
| Enumeration Date | 2020-12-20 | 
| Last Update Date | 2025-03-22 |