| NPI | 1780125302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP133899) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 2017003142) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 2017003142) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 2017003142) | |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-10-05 |