| NPI | 1659726917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN272269) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: TX AP130859) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP130859) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2018-03-17 |