NPI | 1063965978 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131092) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 283632) |
Enumeration Date | 2016-07-27 |
Last Update Date | 2024-08-14 |