NPI | 1619433307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 819129) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140667) |
Enumeration Date | 2019-02-18 |
Last Update Date | 2024-07-01 |