NPI | 1376298315 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1072782) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 787685) |
Enumeration Date | 2022-02-17 |
Last Update Date | 2022-10-31 |