NPI | 1366569675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1084843) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 567762) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1084843) | |
Enumeration Date | 2007-03-23 |
Last Update Date | 2024-06-17 |