NPI | 1154961811 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142591) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11006677) |
Enumeration Date | 2020-01-10 |
Last Update Date | 2024-06-11 |