NPI | 1659992915 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1031105) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178749) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: TX 1031105) | |
Enumeration Date | 2020-04-28 |
Last Update Date | 2024-09-13 |