NPI | 1003337205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2385399) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134297) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2024-06-18 |