NPI | 1003580614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046539) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1046539) |
Enumeration Date | 2021-08-06 |
Last Update Date | 2023-04-28 |