NPI | 1386268605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10226062-4405) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: UT 10226062-3102) |
363L00000X Nurse Practitioner (Licence: UT 10226062-4405) | |
Enumeration Date | 2020-06-02 |
Last Update Date | 2021-12-20 |