NPI | 1114435518 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014551) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3011848) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3011848) | |
Enumeration Date | 2018-01-19 |
Last Update Date | 2022-01-20 |