NPI | 1124728340 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1127842) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95019282) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11011084) | |
Enumeration Date | 2023-03-07 |
Last Update Date | 2024-09-19 |