NPI | 1104301860 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138980) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP138980) |
Enumeration Date | 2018-09-28 |
Last Update Date | 2024-06-26 |