NPI | 1205358348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1001196) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22806) |
Enumeration Date | 2017-07-11 |
Last Update Date | 2022-11-30 |