NPI | 1417587973 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1017551) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95013481) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2023-12-04 |