NPI | 1205554532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1090563) |
Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: TX 1090563) |
363L00000X Nurse Practitioner (Licence: TX 1090563) | |
Enumeration Date | 2022-08-22 |
Last Update Date | 2023-11-08 |