NPI | 1558790303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1128155) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013364) |
Enumeration Date | 2013-11-02 |
Last Update Date | 2024-05-02 |