| NPI | 1962947242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP132792)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP132792)  | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP132792)  | |
| Enumeration Date | 2016-12-22 | 
| Last Update Date | 2021-12-05 |