NPI | 1619646262 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1166657) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182084) |
Enumeration Date | 2021-09-08 |
Last Update Date | 2024-08-19 |