NPI | 1518317304 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1156716) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9371206) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN293548) | |
Enumeration Date | 2016-06-13 |
Last Update Date | 2024-04-19 |