NPI | 1730448085 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128167) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009201) |
Enumeration Date | 2012-05-08 |
Last Update Date | 2015-12-28 |