NPI | 1194110924 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127832) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22444) |
Enumeration Date | 2015-03-30 |
Last Update Date | 2023-07-11 |