| NPI | 1932710993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 116498) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: VA 0024179993) |
| 363L00000X Nurse Practitioner (Licence: VA 0024179993) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179993) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2024-07-18 |