NPI | 1255163408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1164151) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1164151) |
Enumeration Date | 2024-08-16 |
Last Update Date | 2025-05-29 |