NPI | 1184359762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1153490) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025344) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN21017493) | |
Enumeration Date | 2022-07-19 |
Last Update Date | 2024-11-07 |