NPI | 1053568642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129655) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704247034) |
Enumeration Date | 2008-08-26 |
Last Update Date | 2023-03-07 |