NPI | 1689236077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10024300-APRN) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP141935) |
363L00000X Nurse Practitioner (Licence: NH 092344-23) | |
Enumeration Date | 2019-07-05 |
Last Update Date | 2024-06-13 |