| NPI | 1275193344 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AG02190088)  | 
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 802535)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AG02190088)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AG02190088)  | |
| Enumeration Date | 2019-06-19 | 
| Last Update Date | 2019-06-19 |