NPI | 1508157975 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R194814) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 799438) |
Enumeration Date | 2011-04-20 |
Last Update Date | 2023-11-01 |