NPI | 1356008130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1054518) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1054518) |
Enumeration Date | 2021-11-29 |
Last Update Date | 2024-12-17 |