| NPI | 1972212520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1094917) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1094917) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1094917) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1094917) | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-03-04 |