NPI | 1104250216 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9221626) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1059428) |
363L00000X Nurse Practitioner (Licence: FL APRN9221626) | |
363LF0000X Nurse Practitioner, Family (Licence: TX 1059428) | |
Enumeration Date | 2013-08-26 |
Last Update Date | 2023-10-20 |