| NPI | 1669015749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP138610) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP138610) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TX AP138610) | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-10-06 |