NPI | 1053031229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1087997) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1087997) |
Enumeration Date | 2022-08-29 |
Last Update Date | 2024-10-22 |