NPI | 1649642901 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 56518) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129481) |
Enumeration Date | 2015-10-27 |
Last Update Date | 2019-09-16 |