NPI | 1306512462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1003210) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1003210) |
Enumeration Date | 2021-08-19 |
Last Update Date | 2024-08-12 |