NPI | 1609561000 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1112658) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 880531) |
Enumeration Date | 2023-04-10 |
Last Update Date | 2023-05-06 |