| NPI | 1063936540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP134511) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 1063936540) |
| 364SA2200X Clinical Nurse Specialist, Adult Health (Licence: TX AP134511) | |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2018-07-09 |