NPI | 1386003036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX A130258) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX A130258) |
Enumeration Date | 2016-02-22 |
Last Update Date | 2024-05-01 |