| NPI | 1770998205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP127814) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H-118458) |
| 363L00000X Nurse Practitioner (Licence: IA J-118458) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2016-05-17 |