| NPI | 1215027842 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 200049-4405) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 200049-4405) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 200049-4405) | |
| Enumeration Date | 2006-10-13 | 
| Last Update Date | 2021-10-21 |