NPI | 1508469099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 857759) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: TX 857759) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1031534) | |
Enumeration Date | 2020-11-18 |
Last Update Date | 2024-09-12 |