| NPI | 1902521008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1103041) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 904370) |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2022-12-20 |