NPI | 1154789097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130192) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340963) |
Enumeration Date | 2016-02-06 |
Last Update Date | 2022-06-28 |