NPI | 1124333299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 800018) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 67755) |
Enumeration Date | 2010-08-13 |
Last Update Date | 2012-04-16 |