NPI | 1184140642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11450499-4405) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP134308) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2019-12-23 |