NPI | 1871143560 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP142629) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 811769) |
Enumeration Date | 2019-09-16 |
Last Update Date | 2019-10-07 |