| NPI | 1275076697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP131867) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX AP131867) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP131867) | |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2023-08-30 |