NPI | 1265162408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 237218) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1082976) |
Enumeration Date | 2022-06-11 |
Last Update Date | 2025-04-16 |