NPI | 1629812797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1159006) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 79706) |
Enumeration Date | 2024-06-24 |
Last Update Date | 2024-06-27 |