NPI | 1003235672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP125452) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 684218) |
Enumeration Date | 2014-04-10 |
Last Update Date | 2024-05-08 |