NPI | 1063750057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP124311) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F1212401) |
Enumeration Date | 2013-01-25 |
Last Update Date | 2022-11-09 |