NPI | 1104304278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138522) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 786131) |
Enumeration Date | 2018-08-01 |
Last Update Date | 2021-12-27 |