| NPI | 1093350696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 43850) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 43850) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 43850) | |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |