| NPI | 1912390642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2364320) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 810278) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP127628) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2022-12-13 |