NPI | 1487175048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1132148) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 718665-1) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704335813) | |
Enumeration Date | 2017-07-03 |
Last Update Date | 2024-10-18 |