| NPI | 1902561608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1069094) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1069094) |
| 163WG0000X Registered Nurse, General Practice (Licence: IL 041459331) | |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2025-10-03 |