NPI | 1700534716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1074764) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 827877) |
Enumeration Date | 2022-03-17 |
Last Update Date | 2022-12-01 |