NPI | 1710582572 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1047836) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 731207) |
363L00000X Nurse Practitioner (Licence: TX 1047836) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1047836) | |
Enumeration Date | 2020-12-01 |
Last Update Date | 2024-04-19 |