| NPI | 1174251326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1100508) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1100508) |
| 163W00000X Registered Nurse (Licence: TX 865516) | |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2023-07-31 |