| NPI | 1710357538 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP129043) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP129043) | 
| Enumeration Date | 2015-10-06 | 
| Last Update Date | 2016-11-22 |