NPI | 1124750278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1085983) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1085983) |
Enumeration Date | 2022-06-28 |
Last Update Date | 2024-02-23 |