| NPI | 1962035337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP145764) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 788601) |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-04-13 |