NPI | 1700144409 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 2011012536) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 819374) |
Enumeration Date | 2012-05-01 |
Last Update Date | 2024-02-12 |