NPI | 1114308673 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP128153) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP128153) |
Enumeration Date | 2015-06-10 |
Last Update Date | 2021-01-12 |