NPI | 1053917773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1095858) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 211912) |
Enumeration Date | 2020-12-08 |
Last Update Date | 2024-03-11 |