NPI | 1154371466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 324632-4405) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 324632-4405) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 324632-4405) | |
Enumeration Date | 2006-05-10 |
Last Update Date | 2021-11-08 |