| NPI | 1306942263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 612129) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 612129) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 612129) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2017-02-17 |