NPI | 1689002867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 777785) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY F338415-01) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00453500) | |
Enumeration Date | 2013-10-24 |
Last Update Date | 2025-09-04 |