NPI | 1063981074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139953) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 773972) |
Enumeration Date | 2018-11-19 |
Last Update Date | 2019-07-10 |