NPI | 1265857791 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 290604) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 791566) |
Enumeration Date | 2014-02-20 |
Last Update Date | 2025-02-05 |