| NPI | 1659745800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP125011) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP125011) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP017160) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2022-02-08 |