NPI | 1205424694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1035445) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL rn9387682) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN301656) | |
Enumeration Date | 2021-01-02 |
Last Update Date | 2024-10-11 |