NPI | 1194010769 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F0511082) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 17985) |
Enumeration Date | 2011-06-12 |
Last Update Date | 2012-10-05 |