NPI | 1013736321 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1090180) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11036300) |
363LF0000X Nurse Practitioner, Family (Licence: OH 0038028) | |
Enumeration Date | 2024-10-04 |
Last Update Date | 2024-11-14 |