NPI | 1083466403 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1156415) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2024-04-02 |
Last Update Date | 2024-05-06 |