NPI | 1003640350 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 234912) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1173213) |
363L00000X Nurse Practitioner (Licence: LA 237009) | |
Enumeration Date | 2024-08-29 |
Last Update Date | 2025-10-10 |