NPI | 1023620143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1108517) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV 840576) |
363LF0000X Nurse Practitioner, Family (Licence: TX 110851712) | |
Enumeration Date | 2020-08-19 |
Last Update Date | 2024-07-30 |