NPI | 1093338345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1036437) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71013106A) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3018187) | |
Enumeration Date | 2020-05-21 |
Last Update Date | 2024-09-24 |