| NPI | 1104329218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP133917) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP133917) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP133917) | |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2023-12-06 |