NPI | 1639820830 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1049188) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1049188) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1049188) | |
Enumeration Date | 2022-01-10 |
Last Update Date | 2022-01-10 |