NPI | 1043396344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP115627) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704158501) |
363LF0000X Nurse Practitioner, Family (Licence: NV APRN001909) | |
Enumeration Date | 2006-10-29 |
Last Update Date | 2020-04-24 |