| NPI | 1780223412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1035646) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1035646) |
| 363L00000X Nurse Practitioner (Licence: CA 95012935) | |
| Enumeration Date | 2019-12-28 |
| Last Update Date | 2021-12-30 |