NPI | 1568875003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125924) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2001004918) |
Enumeration Date | 2014-06-03 |
Last Update Date | 2021-09-29 |