| NPI | 1609957265 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 600599) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 600599) | 
| Enumeration Date | 2006-10-18 | 
| Last Update Date | 2011-09-08 |