NPI | 1578127767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 30220) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141020) |
363L00000X Nurse Practitioner (Licence: CA 95022818) | |
Enumeration Date | 2019-04-24 |
Last Update Date | 2025-05-29 |