NPI | 1235605726 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 78808) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1022179) |
Enumeration Date | 2018-10-23 |
Last Update Date | 2022-02-23 |