NPI | 1417656158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1111712) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1111712) |
Enumeration Date | 2023-03-02 |
Last Update Date | 2024-11-07 |