NPI | 1083351498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11780315-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 11780315-3102) |
Enumeration Date | 2022-05-17 |
Last Update Date | 2024-06-18 |