NPI | 1407637606 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1127910) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1127910) |
Enumeration Date | 2023-10-12 |
Last Update Date | 2024-02-05 |