| NPI | 1679946008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: SC AP129484) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 758324) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: TX AP129484) | |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2020-05-21 |