NPI | 1679947618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130091) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 875368) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2021-12-01 |