NPI | 1205619053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1130613) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 33392) |
Enumeration Date | 2023-08-16 |
Last Update Date | 2023-08-16 |