| NPI | 1952753949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP131155) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP131155) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016012207) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2016012207) | |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-07-01 |