NPI | 1255093134 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140621) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN293993) |
Enumeration Date | 2021-10-08 |
Last Update Date | 2021-10-08 |