NPI | 1750630364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07010) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136950) |
Enumeration Date | 2012-08-29 |
Last Update Date | 2023-04-11 |