NPI | 1396115903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 27259.1438) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141551) |
Enumeration Date | 2015-09-25 |
Last Update Date | 2021-03-05 |