| NPI | 1679104954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP145144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 653398) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP145144) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2021-05-19 |