NPI | 1083190789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1027622) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV 811112) |
Enumeration Date | 2018-07-16 |
Last Update Date | 2025-03-28 |