| NPI | 1639839277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX Ag12210088) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX Ag12210088) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX Ag1220088) | |
| Enumeration Date | 2021-12-22 |
| Last Update Date | 2024-07-06 |