NPI | 1366174377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10778291-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 10778291-3102) |
Enumeration Date | 2022-06-28 |
Last Update Date | 2022-07-13 |