NPI | 1235501263 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10574) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129516) |
Enumeration Date | 2015-10-29 |
Last Update Date | 2017-10-13 |