NPI | 1508405028 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014028) |
Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: OK 95760) |
363LF0000X Nurse Practitioner, Family (Licence: OK F05200738) | |
Enumeration Date | 2019-12-31 |
Last Update Date | 2020-10-20 |