| NPI | 1942895719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 311263) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 311263) |
| 363L00000X Nurse Practitioner (Licence: TX 1014702) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1014702) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1014702) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1014702) | |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2024-03-16 |