NPI | 1184976615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1054327) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9291944) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024172556) | |
Enumeration Date | 2012-10-08 |
Last Update Date | 2023-01-27 |