NPI | 1255528303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046788) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005526) |
363LF0000X Nurse Practitioner, Family (Licence: NC 249962) | |
363LF0000X Nurse Practitioner, Family (Licence: PA SP009542) | |
Enumeration Date | 2007-10-02 |
Last Update Date | 2022-01-10 |