NPI | 1366706921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122345) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 717451) |
Enumeration Date | 2012-06-28 |
Last Update Date | 2021-10-13 |