NPI | 1124619424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1036638) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX RN863835) |
Enumeration Date | 2021-01-29 |
Last Update Date | 2024-07-05 |