NPI | 1639654833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61641289) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP143061) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2025-01-08 |