NPI | 1578063624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1116344) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 790756) |
Enumeration Date | 2018-02-15 |
Last Update Date | 2023-09-22 |