NPI | 1104172907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP121860) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 771591) |
Enumeration Date | 2012-07-30 |
Last Update Date | 2023-02-28 |