NPI | 1366831612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126871) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP126871) |
363LF0000X Nurse Practitioner, Family (Licence: TX 622606) | |
Enumeration Date | 2015-01-09 |
Last Update Date | 2024-11-07 |