NPI | 1124269899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 714766) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 469271) |
Enumeration Date | 2009-03-10 |
Last Update Date | 2009-03-11 |