NPI | 1083108039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1040937) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: HI APRN-2846) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2022-01-12 |