| NPI | 1164846408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP128237) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TX AP128237) |
| 363L00000X Nurse Practitioner (Licence: NC 5006725) | |
| 363L00000X Nurse Practitioner (Licence: TX AP128237) | |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2024-04-02 |