| NPI | 1679511653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX 633569) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 633569) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 633569) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-10-17 |