NPI | 1548403629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138667) |
Additional Taxonomies | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
Enumeration Date | 2009-04-20 |
Last Update Date | 2019-04-15 |