| NPI | 1700352135 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP139295) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP) | 
| Enumeration Date | 2018-10-24 | 
| Last Update Date | 2018-10-24 |