NPI | 1568076537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1017269) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX F08201162) |
Enumeration Date | 2020-09-07 |
Last Update Date | 2023-06-23 |