NPI | 1184321747 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1113205) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F351259-01) |
Enumeration Date | 2023-02-13 |
Last Update Date | 2023-07-28 |