| NPI | 1659112324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1151439) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1151439) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1151439) | |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-11-08 |