| NPI | 1770455875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1215424) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 902264) |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-10-16 |