NPI | 1659732865 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011225) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 130113) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5011225) | |
Enumeration Date | 2016-03-15 |
Last Update Date | 2020-06-30 |