NPI | 1700109550 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16933) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 137663) |
363LF0000X Nurse Practitioner, Family (Licence: CA 18670) | |
Enumeration Date | 2010-03-08 |
Last Update Date | 2018-08-17 |