NPI | 1205392594 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141531) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F01190550) |
Enumeration Date | 2019-02-12 |
Last Update Date | 2022-05-12 |