| NPI | 1740648419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TN 25502) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP130267) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 25502) | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-03-23 |