| NPI | 1013364439 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 618490) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 163WG0000X Registered Nurse, General Practice (Licence: TX 618490) | |
| 163WN1003X Registered Nurse, Nutrition Support (Licence: TX 618490) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2019-01-18 |