NPI | 1669044624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10496639-4405) |
Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: UT 10496639-3102) |
Enumeration Date | 2021-07-10 |
Last Update Date | 2023-08-08 |