| NPI | 1942620588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP125552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP125552) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP125552) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2026-06-24 |