NPI | 1295127306 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126375) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95001699) |
Enumeration Date | 2015-02-26 |
Last Update Date | 2015-11-12 |