NPI | 1255787396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7813) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129559) |
Enumeration Date | 2016-05-08 |
Last Update Date | 2024-09-26 |