NPI | 1124682877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902786) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141508) |
Enumeration Date | 2019-04-29 |
Last Update Date | 2024-06-26 |