NPI | 1174247779 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1000137) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021726) |
Enumeration Date | 2022-09-28 |
Last Update Date | 2022-11-24 |