NPI | 1457774283 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 787922) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP124575) |
Enumeration Date | 2014-01-30 |
Last Update Date | 2018-02-12 |