| NPI | 1912617663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1099779) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1099779) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1099779) | |
| Enumeration Date | 2022-12-02 |
| Last Update Date | 2022-12-02 |