NPI | 1003476789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141881) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: TX 841606) |
Enumeration Date | 2019-06-16 |
Last Update Date | 2023-11-13 |